Barriers to health service access among female migrant Ugandan sex workers in Guangzhou, China

Int J Equity Health. 2016 Oct 14;15(1):170. doi: 10.1186/s12939-016-0453-2.


Background: Increased trade between China and Uganda has fueled trafficking of female Ugandans into China. These women may face challenges accessing health services. This study focused on examining barriers to health care access among female Ugandan sex workers in China.

Methods: In 2014, we undertook in-depth interviews with 19 female Ugandan sex workers in Guangzhou, China. Interviews focused on barriers to health service access and were analyzed using an a priori coding framework followed by open-coding to capture emergent themes.

Results: Out of 19 women, 12 women reported a history of being trafficked into China. None of the women had a valid Chinese visa. Fear of being arrested for lack of documentation discouraged women in this sample from accessing hospital services. Low pay, housing exploitation, and remittances contributed to participants' lack of financial resources, which further inhibited their ability to access health services. Participants expressed feeling social isolation from the local community and reported mistrust of local individuals and organizations, including hospitals.

Conclusion: Ugandan sex workers in China faced substantial structural barriers that limited health service access. Policy changes and the development of new programs are urgently needed to ensure these women have improved access to health services.

Keywords: China; Female sex workers; Health care access; Migrants; Uganda.

MeSH terms

  • Adult
  • China / epidemiology
  • Female
  • Health Services Accessibility*
  • Humans
  • Interviews as Topic
  • Sex Workers / psychology*
  • Socioeconomic Factors
  • Transients and Migrants / psychology*
  • Uganda / ethnology